A medical nurse is caring for a patient with type 1 diabetes. The patient's medication administration record includes the administration of regular insulin three times daily. Knowing that the patient's dinner tray will arrive at 1645, when should the nurse administer the patient's insulin to ensure the onset of the insulin coincides with the start of the meal?

1645

1615

1545

1600

Answer and Explanation

The Correct Answer is B

A. Regular insulin typically begins to take effect 30 minutes after administration. Administering insulin at the time of the meal (1645) would not allow enough time for the insulin to reach its onset of action, potentially resulting in the blood glucose level being high during the meal.

B. Regular insulin has an onset of action of 30 minutes. By administering the insulin at 1615, it will start to take effect by 1645, when the meal arrives, and help ensure the insulin action aligns with the meal, preventing postprandial hyperglycemia.

C. Administering insulin at 1545 would be too early and could lead to the insulin peaking before the meal, which could result in hypoglycemia if the insulin peak occurs before the patient has food to absorb the glucose.

D. Administering insulin at 1600 would result in the insulin starting to work too soon, with the onset happening before the meal and possibly leading to hypoglycemia if the insulin peaks before the meal is consumed.

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Correct Answer is D

Explanation

A. Aspirin Toxicity:
Effect on Blood Gases: Aspirin toxicity can cause respiratory alkalosis due to increased respiratory rate (hyperventilation), leading to a decreased PaCO2 and increased pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values (low PaCO2 and high pH), making it a possible cause.

B. Fever:
Effect on Blood Gases: Fever might cause hyperventilation, resulting in respiratory alkalosis with decreased PaCO2 and increased pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values.

C. Anxiety Attack:
Effect on Blood Gases: Anxiety attacks can lead to hyperventilation and subsequent respiratory alkalosis with low PaCO2 and high pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values.

D. Chronic Obstructive Pulmonary Disease (COPD):
Effect on Blood Gases: COPD typically causes respiratory acidosis due to impaired gas exchange, resulting in elevated PaCO2 and decreased pH.
Relation to Given Blood Gases: COPD wouldn't typically cause the observed blood gas values of low PaCO2 and high pH.

A. 30 minute onset; 2 hour duration B. 15 minute onset; 30-60 minutes peak C. 2 hour onset; 12 hour duration D. 15 minute onset; no peak (continuous)

Correct Answer is B

Explanation

A. 30 minute onset; 2-hour duration: This does not accurately represent the onset and peak action time of Insulin Lispro.

B. 15 minute onset; 30-60 minutes peak: This is correct. Insulin Lispro has a rapid onset (starts working within 15 minutes) and a peak action time of 30-60 minutes after administration.

C. 2-hour onset; 12-hour duration: This is not accurate for rapid-acting insulin. Rapid-acting insulin has a much quicker onset and shorter duration compared to this option.

D. 15 minute onset; no peak (continuous): While the onset time is correct, stating "no peak" is not entirely accurate. Rapid-acting insulin does have a peak, but it's relatively short, occurring within the first hour after administration.

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Naxlex Comprehensive Predictor Exams

A patient has the following blood gases: PaCO2 33, pH 7.50, HCO3 23. Which of the following could NOT be the cause of this condition?

Correct Answer is D

Explanation

A client with diabetes mellitus is ordered to receive insulin for glucose correction (sliding scale coverage). The nurse knows the rapid acting insulin Insulin Lispro (Humalog) onset and peak action time are:

Correct Answer is B

Explanation

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